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Organization
OPENSMILEDENTAL
Active
Organization
OPENSMILEDENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH A PHILLIPS DDS (PRESIDENT)
(718) 523-5776
Entity
Organization
Contact information
Practice address
10753 GUY R BREWER BLVD, JAMAICA, NY 11433-2351
(718) 523-5776
Mailing address
10753 GUY R BREWER BLVD, JAMAICA, NY 11433-2351
(718) 523-5776
(718) 526-1132
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
028846
NY
Other
Enumeration date
11/18/2016
Last updated
11/18/2016
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